Striae also known as stretch marks, striae atrophicae, vergetures, striae distensae, striae cutis distensae, striae gravidarum, lineae atrophica and linea albicante. Striae are a scarring of skin by separation of dermal elastic and fibrous tissues, commonly seen after pregnancy and loss of weight in obese patients. Abdomen is stretched considerably in obesity and pregnancy. After pregnancy and loss of weight in obesity stretch marks are very noticeable and detected in abdominal wall

Surgical Scars: In most of the cases, scar is seen as a normal healing scar. In few cases, it may be presented as keloid or infected scar tissue.

Spider nevus of the abdominal wall: Also known as spider angioma and vascular spider. It is presented with central red bright spot of dilated arterioles and radiating branches spreading outward as spider web of venous branches carrying blood away from central arterioles. They are benign and seen in liver disease.

Palpation Of The Abdomen:

After inspection, the patient is examined with palm and fingers of one or both hands. Palpation is either gentle superficial and deep or vigorous superficial and deep.

Intra-abdominal Crepitus: Palpation may produce a sound and feel of crepitus. Crepitus is a crackling and popping sound. Intra-abdominal crepitus is observed in necrotizing enterocolitis occurs in premature infants.

Flank: Renal cysts, polycystic kidneys, and renal malignancies may all be visible in asthenic patients.

Lower Quadrants: Inflammatory or neoplastic disorders of the intestine. In the right lower quadrant appendicular abscess and cecal carcinoma are most likely, while in the left lower quadrant diverticular abscess or carcinoma of the sigmoid colon is most likely.

Rebound Tenderness (Rovsing's sign): Tenderness and rebound tenderness on palpation. This is seen in appendicitis, peritonitis and ulcerative colitis.

Auscultation Of The Abdomen:

Normal Peristalsis: Normal peristalsis of the intestine produces bowel sounds as gas and fluid are passed through the intestinal lumen. Normally, the bowel sounds are intermittent, low-pitched, chuckling sounds. Bowel sounds may be decreased or increased in few diseases.

Vascular Bruits: Audible turbulent blood flow conducting swishing sound over major arteries during systole. Observed in aortic aneurysm and atherosclerosis of aorta and renal artery. Occasional bruits are heard during systole and diastole in a patient suffering with arteriovenous communications.

Crepitus: Sound is produced by friction between gas and fluid within the viscous of organ or air entrapped in subcutaneous tissue following infection such as gas gangrene. Penetrating chest wall injury can cause subcutaneous emphysema secondary to air leaking from alveoli into subcutaneous tissue through a track of air fistula. Post surgery claustredial infection can cause intra-abdominal gas gangrene.